AANA journal
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Randomized Controlled Trial Clinical Trial
Is there postoperative evidence of implicit learning following aural stimuli at moderate hypnotic BIS levels during general anesthesia?
Patients may develop behavioral changes after the administration of a general anesthetic without a triggering stimulus. This phenomenon, referred to as implicit learning, continues to be debated. Some researchers have denied the phenomenon takes place, while others have demonstrated behavioral changes not related to recall. ⋯ A posttest was administered to determine explicit recall, as well as implicit memory formation. No patients had explicit recall. There was no difference in the implicit memory scores between patients in the experimental group and the control group.
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Case Reports
Continuous spinal anesthesia for cesarean section for a morbidly obese parturient patient: a case report.
This case report details the successful anesthetic management of a morbidly obese parturient patient who presented for a repeat, elective cesarean section. The preanesthetic evaluation and the indications for choosing a continuous spinal anesthetic are discussed. Evaluation of the anesthetic plan is also discussed through a review of the postoperative scenario.
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The study of anesthesia risk is fraught with methodological challenges and the epidemiological uncertainty peculiar to anesthesia: the true frequency of anesthetic mortality is unknown. If anesthesia mortality is as rare as 1 in 200,000 cases, the sample needed to study this phenomenon would be enormous. Existing studies provide insights to the genesis of damaging events and adverse outcomes in anesthesia. ⋯ Nurse anesthetist investigators had similar findings for respiratory claims. Patient acuity and procedure complexity may be less significant contributory factors to anesthesia risk than are provider vigilance and clinical decision making. Prospective multicenter studies conducted politically may be the only type of research that definitively addresses the myriad issues in anesthesia risk research.
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Hypothermia frequently is considered inadvertent in the perioperative setting. The preservation of vital body heat has been an issue since the 1800s. ⋯ Providing patients with an environment designed to foster normothermia can preclude the costs of longer hospital stays, prevent morbid conditions associated with hypothermia, and provide patients with a more comfortable perioperative experience. Our goal as perioperative healthcare providers is a normothermic perioperative experience for all patients.